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AS₂I 2019 Scholarship Application

3. 

5. The AS₂I scholarship application deadline is <strong>June 28, 2019</strong>. If you have any questions, please contact S.T.E.M. Coordinator Aileen McManus at (407) 571-8856.

   The AS₂I scholarship application deadline is June 28, 2019. If you have any questions, please contact S.T.E.M. Coordinator Aileen McManus at (407) 571-8856.

7. STUDENT INFORMATION:

9. First Name:*

10. Last Name*

12. Address:*

14. City:*

15. State:*

16. Zip:*

18. Email:*

19. Phone Number:*

21. Parent/Guardian Name:*

22. Phone Number:*

24. SCHOOL INFORMATION:

26. High School:*

27. Grade:*

28. GPA:*

30. Anticipated Graduation Date:*

32. Have you participated in the AS₂I program?*

    1. Yes
    2. No

33. If yes, list the year you attended and name of participating school.*

35. Have you participated in the AS2I internship program?*

    1. Yes
    2. No

36. If yes, which year did you intern?

38. Which career field(s) are you interested in exploring after high school?

40. Have you been accepted to an accredited public or private Florida college or university? If so, which ones?

42. Which semester will you enroll?

    1. Summer 2019
    2. Fall 2019
    3. Spring 2020

43. Are you planning on enrolling as a full-time or part-time student?

    1. Full Time
    2. Part Time

45. Please list and describe your volunteer experiences or extracurricular activities:

47. ESSAY:

49. In 500 words, describe your goals and aspirations to pursue a S.T.E.M.-related career and how you will use your education to contribute to your community.*

51. SUPPORT DOCUMENTATION:

    If you have multiple documents, please combine them in a zipped file. Be sure to include your name in the filename (e.g., AS2I Scholarship Form_John Smith).

    If you have multiple documents, please combine them in a zipped file. Be sure to include your name in the filename (e.g., AS2I Scholarship Form_John Smith).

53. Upload your required forms.*

55. By submitting this application, you agree that all information is accurate and up to date.

57. Date:*
    Date:

Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field